Provider Demographics
NPI:1770076804
Name:NOMIKOS, CARRIE (PA-C)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:NOMIKOS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:
Other - Last Name:KWOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2189 SECOND STREET PIKE
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-4134
Mailing Address - Country:US
Mailing Address - Phone:215-598-1200
Mailing Address - Fax:215-598-1201
Practice Address - Street 1:2189 SECOND STREET PIKE
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-4134
Practice Address - Country:US
Practice Address - Phone:215-598-1200
Practice Address - Fax:215-598-1201
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA007403207Q00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant